MOTIVATING HELMETS: How Convince People To Buckle Up

August 2, 2012

There is little question that if you have a bicycle accident, and if your head gets banged, and if it isn’t so severe that you’re dead anyway, then your injuries are likely to be significantly less severe if you are wearing a helmet.  I once had a dent in an old helmet that proved the point to my own satisfaction.

And I’m amazed at how often anti-bicycle people use a cyclist’s uncovered head  as “proof” of the rider’s immaturity and irresponsibility – thereby justifying the critic’s condemnation of everyone who bikes.

But how to convince people to put the helmet on? 

Research says that the most common non-compliance reasons are that the person doesn’t own a helmet, that it feels too hot, that they don’t like the way a helmet makes them look, or that it shouldn’t be needed for short trips. Boston is using several strategies to provide high quality helmets at little or no cost, with the Boston Cyclist’s Union playing a major role.  Hubway is working with an MIT team to create helmet vending machines to place next to their stations although there are lots of technical deployment issues still to solve.

THE PROBLEM WITH YOUNG PEOPLE TODAY

While helmet-refusal occurs among all age groups, races, and genders the people least likely to use bike helmets are ages 18 to 24:  college students, although teenagers aren’t far behind.  As usual, this is not an income-neutral problem:  Boston’s Public Health Commission is increasingly disturbed by the numbers of low-income kids arriving in Emergency Rooms with split skulls.  It’s a complex situation, especially since the evidence suggests that requiring helmet use reduces the number of people willing to bike, thereby undermining two key public health benefits of increased cycling:  the huge public (and individual) health benefits of that activity (of particular relevance to low-income children) and the “safety in numbers” dynamic that lowers the rate of car-bike accidents as the number of cyclists increases.

My teenage son was once caught cycling with his helmet hanging from the handlebar.  “I took the helmet,” he told his mother, “and if I fall I’ll put it on.”  Would it have been better to punish him for the safety violation or to applaud his health-promoting willingness to be “uncool” by traveling outside of a car?  Or just appreciate his sense of humor?

CHANGING THE COOL

The definition of “coolness” does change.  Last winter I went downhill skiing for the first time in many years.  Besides the amazing improvement in my ability to remain upright caused by today’s short, hour-glass skis, the most surprising change was the huge percentage of younger skiers who were wearing helmets.  What happened?  Probably Xtreme Sports.  Snowboarding tournaments feature young athletes doing incredible stunts – and wearing helmets.  The same kids who do downhill watch those events on TV.  TV makes the athletes celebrities and therefore cool, so wearing helmets became cool, too.

On the other hand, skateboarding contests also require participants to wear helmets, but that doesn’t seem to have flowed over to street behaviors.  It is likely that higher-income demographics of skiing families play a role.

Still, sometimes habits sometimes change, even when triggered by official requirements.  The first attempt to mandate seatbelts in Massachusetts sparked a Tea Party-like right-wing revolt against this “attack on our freedom.”  Even today, not wearing a seatbelt is a “secondary” violation for adults in Massachusetts – meaning that you can only be cited if you’ve been already pulled over for some other reason.

But my kids grew up with seatbelts and they wear them without question.  Now, it even feels funny to me to sit in a car without buckling up.  As does riding a bicycle without a helmet – I absentmindedly took off the other day and suddenly realized that the wind in my hair felt good but disconcerting.  I went back and put on the helmet.

ALTERNATIVE STRATEGIES — STICKS AND…

Some people say that requiring helmets may cause a temporary drop in ridership but will lead to long-term acceptance.  I doubt it.  Teenagers under age 16 are already legally required to wear helmets, a fact they mostly seem to ignore.  Perhaps increased enforcement might raise their compliance rate (is that what we really want our police to spend time on?), but I suspect it’s more likely to simply turn more of them into scoff-laws.  And college students are generally convinced of their own immortality as well as secure enough in their class privileges to generally ignore or flaunt the rules.

So swinging sticks is probably not the best strategy.  How about carrots?  Some cities have “helmet reward” programs where police give coupons for ice cream or other treats to kids they see wearing a helmet.

Bribery is nice, but probably of limited impact.  What would it take to make bike helmets “cool?”   This requires methods of linking directly into the culture of the groups we’re trying to communicate with.  We can learn from the skiers:  perhaps the spread of bicycle racing might have the same effort as snowboarding, creating local celebrities who inspire emulation – especially if the races are televised (CCTV?).  So maybe the Public Health Commission should put some energy (and money) into sponsoring bike racing teams at local High Schools!

Or what about rap stars performing in a bike helmet?  Ok, not a go….

Maybe we can learn from the anti-smoking campaigns.  It wasn’t the pictures of diseased lungs that turned teenagers’ heads.  It was making smokers look socially stupid – the boy leaving the bathroom after a quick butt with toilet paper stuck to his shoe:  “stupid for two reasons.”  Anti-drug educators went for the gross:  the fried egg as “your brain on drugs.”

NEGATIVE AND POSITIVES

Fear also works – horror movies are big hits among that age group!    The Boston Public Health Commission is working on a campaign showing a young person’s bruised up face asking “still think helmets will mess up your hair?” with the tag line: “there are no good excuses.”

But scaring people about the dangers of bicycling without a helmet may undermine the larger benefit of getting more people to cycle.  Already, the primary reason people give for not bicycling is that it seems dangerous – mostly because of the proximity of cars.  Maybe we should be trying to increase the fear of dangerous behaviors among car drivers rather than bicyclists!

The best approach is to combine the negative and the positive.  How about a campaign around the slogan:  “Does she like your pretty face?  Keep it that way!” — showing someone after an accident, or maybe contrasting the happy couple with the lonely injured one.

Which brings us to the real motivator.  Of course.  Sex.  It seems to sell everything else. Here are some possible slogans — “Don’t forget your protection as you ride over for your date!” or “Only fools take chances with life, and with death – stay protected outdoors as well as inside!”  or “Keep your head intact…..”

This could be fun!

———————-

Related previous posts:

>BIKE HELMETS, CRASH SAFETY, AND PUBLIC HEALTH: From Anecdote to Evidence

>SAFETY AND THE LAW: When Are Higher Penalties The Right Tool For Changing Behaviors

>SHAPING TRAVEL CHOICES: The Four C’s of the Behavioral Context

 

 

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posted in MAKING BICYCLING MAINSTREAM by Steve Miller

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14 Comments to "MOTIVATING HELMETS: How Convince People To Buckle Up"

  1. Charlie Denison wrote:

    As a bike owner and Hubway rider, I find that when I’m taking my own bike, I wear a helmet nearly 100% of the time. However, when I’m using Hubway, I wear one less than 50% of the time. The reasons for this are:
    - I need to have a place to store the helmet when I get where I’m going. When I’m using my own bike, I can lock the helmet to the bike. When I use Hubway, unless I’m going to work or to someone’s house, I don’t have a place to put the helmet once I get there (i.e. a bar).
    - I often don’t know when I will be using Hubway. Unless I anticipate that I’m going to be using Hubway that day, I won’t think to take my helmet with me.
    - I often use Hubway for only one part of my travel. I may take the T or walk to get somewhere, but then use Hubway to get back or to go somewhere else. Carrying a Helmet all day to use for such a short time is a hassle.

    I do find it true that when I do not wear a helmet, I am extra careful. I bike more slowly and more cautiously, and am more likely to take off-road routes even if they are longer. But in general I have confidence that my safety is largely under my control by operating predictably and anticipating potentially dangerous situations. In my 8+ years of bicycling in and around Boston, I have yet to be in a crash with a car.

    I think providing helmet vending machines for helmets for Hubway is a bit of a losing proposition. Not only will most people not bother to get one, especially if they cost money, I’ve found that adjusting a helmet to one’s head tends to be a non-trivial experience timewise. This doesn’t mean we shouldn’t try to provide the machines, since some people will surely use them, but I wouldn’t expect a majority of Hubway users to do so.

  2. patrick wrote:

    This is the good thing about groups like HELL, and the tendency of folks who are really in the bike scene to wear helmets – they already have the coolness factor and are promoting helmet use.

  3. Jeremy wrote:

    I just don’t get the argument that we should invest a single minute in encouraging people to wear helmets. Yes I’ve heard all the personal horror stories, but I also know that everyone who has ever seen a bicycle knows that it’s a good idea to wear a helmet. Declining to wear a helmet doesn’t make you any more likely to get into a crash.

    Most importantly, it’s not my job as an cycling advocate (and in fact it’s counterproductive) to put fear into people by making bicycling seem far more dangerous than it actually is. I’d much rather someone ride with no helmet than not ride at all.

    Opponents of improved bicycling conditions have very successfully framed bicycling as a dangerous activity and we have been falling for this trap forever. They like to have any excuse they can to blame the victim in a crash. And they know that the more time they can get people who are supposed to be advocating for bicyclists rights/safety to instead focus on individual bicyclist behavior, the less conditions improve for bicyclists on the street.

    Let’s focus our energies instead on increasing actual safety by ensuring proper cycling facilities and that both cities and drivers who put cyclists in danger are held accountable.

  4. Steve Miller wrote:

    Jeremy:

    I, too, worry about reinforcing the general perception that “bicycling is dangerous.” But until our infrastructure is fully developed to provide car-safe routes around the region, and until our culture becomes less addicted to expressing our individualist and aggressive tendencies through car driving, cyclists will be smart to wear helmets. But may there is a way through this contradiction — focusing the pro-helmet campaign on current cyclists rather than the general public. Maybe kids as well. I’m not sure exactly how this could be done — any suggestions?

  5. Steve Miller wrote:

    Patrick:
    Yes, modeling counts. But I think we need more celebrity coverage appropriate for both the teenage African-American male and the college-age white male audience. Every time Tom and Gisele are shone bicycling without helmets the cool balance tips away from us.
    Steve

  6. Steve Miller wrote:

    Charlie:
    The helmet vending machines will make a small difference. But I agree that they won’t change the fundamental problems that you describe. The real solution is better infrastructure — off-road paths, cycletracks, buffered lanes, and other facilities that protect cyclists from cars: there is a reason that so many Danes don’t wear helmets for in-town trips. But even the best surfaces head injuries will remain a problem. My first head-impact bicycle accident was totally self-created: I went around a turn too quickly and flipped on to my helmet.

  7. sam powell wrote:

    DATA or STORIES.
    Below is copied from comments at a published TED talk on helmet use.

    Stories… They’re what humans instinctively use to survive, but using stories as a learning tool is ineffective in a modern world. Anecdotal accounts are possibly the worst form of scientific evidence and most often disingenuous because they turn a blind eye to those incidents when the results that were desired didn’t occur.

    Entire populations have switched to helmet use with little to no change in recorded injuries because the type of injury a helmet can prevent are superficial injuries that often do not get recorded. Despite the very real emotional testimonies that a helmet saved a life, the data doesn’t line up with the claims, in fact, the data often runs contrary to such claims.

    Do the right thing and examine the data on the issue, discover how safe cycling is, how cycling increases lifespan while reducing the odds of receiving the most common form of brain injury (stroke), and most importantly, understand that cycle helmets are designed to mitigate minor head injury only, and not to reduce the chances of death or serious injury on a bicycle.

    Don’t fall for stories. Examine the data.

    http://momentummag.com/videos/mikael-colville-andersen-why-we-shouldnt-wear-bike-helmets/comments.html

  8. sam powell wrote:

    REAL SAFETY Buck Eichler,

    … I am against the unnecessary dangerization of cycling. Cycling is a very safe activity if done right. Forcing me to wear a helmet when riding on a safe trail or street is wrong.

    The fear mongering is North America is very real. Not only in cycling, but by almost anyone selling things that is supposed to make you safer. Someone referred to it as creating the bubble wrap society. The auto industry are constantly advertising how safe
    cars are with all sorts of safety ratings and devices. But in the real world the car is deadly.

    I feel that choice is better and safer. Selecting a safe route to your destination or where to cross busy highway are more important that wearing the plastic hat, If you participate in
    more risky activity, then you should choose what is best to make yourself safe and not because it is part of the cool or convention or some non cyclyst in the government says so. Police Officers can spend their time better focusing on dangerous behaviour on the roads as opposed to on cyclists without helmets.

    None of the European countries; Denmark Holland, Germany and others have helmet laws. People don’t wear them because it is unnecessary. It is also a pleasure to cycle in cities in cities in these countries. You don’t have the stress on safe roads.

    We should probably let go of the helmet debate, once the laws are repealed and focus our energy on getting these streets safer and our communities more livable, and enjoy the trails.

  9. sam powell wrote:

    WHY FOCUSING ON HELMETS IS A PROBLEM
    Here are four reasons we should stop focusing on helmets as the first and last word in bike safety:
    1.A helmet does absolutely nothing to prevent a cyclist from getting hit by a car.
    2.The effectiveness of helmets in preventing injury is grossly exaggerated.
    3.Research suggests that cyclists wearing helmets are more likely to get hit by cars, since drivers view them as less vulnerable and pass them more closely.
    4.The attention on helmets leads some local governments to pass mandatory helmet laws, which always have the effect of discouraging cycling, and fewer cyclists on the road makes it more dangerous for those who remain.
    Let’s start with efficacy.  Before 1990, helmet use in the U.S. was rare, and nobody thought anything of it.  Then in the 1990s, helmet use skyrocketed.  So after cyclists started wearing helmets, head injuries among cyclists went down, right?
    No, head injuries went up.  Let me repeat that: When helmet use went up, head injuries went up right along with them.  There’s a big article about this in the New York Times, showing that head injuries among cyclists went up 51% in the 1990′s as more and more cyclists started wearing helmets.
    It’s not clear whether helmets caused the head injuries; there are other plausible explanations for why head injuries increased (more attention to helmets and less attention to safe riding skills being one of them).  But what is clear is that any protective value of helmets is so small it’s hard to measure.
    Most of us have heard that “bicycle helmets can prevent up to 85% of head injuries”.  Typically, no source is ever cited for this 85% figure.  But where did this 85% figure come from, and is it credible?  The answer is that it came from a flawed 1989 study, and it’s probably wildly inaccurate.  The study was roundly criticized in the Helmet FAQ by the Ontario Coalition for Better Cycling and by CycleHelmets.org, which states:
    This paper is by far the most frequently cited research paper in support of the promotion of cycle helmets. It is referred to by most other papers on helmets, to the extent that some other papers, and most helmet promotion policies, rely fundamentally upon the validity of its conclusions.
    The claims that helmets reduce head injuries by 85% and brain injuries by 88% come only from this source, yet are quoted widely as gospel by people who know nothing more about cycle helmets. The prospect of achieving such massive reductions in injuries to cyclists lies at the root of helmet promotion and mandatory helmet laws around the world.
    Those who have taken the trouble to analyse the paper in detail, however, have found it to be seriously flawed and its conclusions untenable.

    CycleHelmets.org has other good information, such as the chart of countries with the most helmet use also have the most head injuries. or go to  bicyclesafe.com

  10. brad wrote:

    New cyclists need good stories from skilled riders that are based on good relevant data.

    Find your self a reputable mentor and don’t discount someone who doesn’t wear a helmet as disreputable.

    A lot of bike messengers wear helmets but according to one of my mentors at bicyclesafe.org …

    “Wearing helmets may make cyclists feel safer and thus take more risks. This effect is known as risk compensation and is consistent with other road safety interventions such as seat belts and anti-lock braking systems.[78][79]
    In tests, adults accustomed to wearing helmets cycled faster when wearing a helmet than without, indicating a higher tolerance for risk.[80][81] Tests also show that children go faster and take more risks when wearing safety gear (including helmets),[82] and that parents allow children to be more risky when using safety gear.[83]”

    After hearing my first graphic description @ 1980 in NYC from a bike messenger’s experience of being door’d i knew that it was very high on my prioritized list of things NOT to do while riding my bike.

    Lucky for me when I heard that story I was in a room of some of the top cycling advocates and safety experts in the world, and I got to hear their analysis of messenger riding technique’s vs safe and sane techniques.

    I’m a bike mechanic and I can fairly easily watch someone “to proud to ask for help” make their own mistakes trying to fix or destroy their own bike.
    However, when it comes to bicycle safety I sincerely hope that most of us can learn to modify our riding behavior based on logical explanations from the skilled cyclists who have learned to do so with ease and safety. Understanding all the nuances of city traffic, HOW TO AVOID THE HIGH RISK ROUTES…The ability to read traffic and know what a slowing down motorist or taxi with or without occupants is up to is enhanced by once being a car driver.

    If you never took drivers ed for driving a car you might want to take a bike riding course thru Boston or Cambridge adult ed classes for Advanced City Cycling or Basic of Better Bicycling courses.

    I hear Boston Cyclist Union is contemplating a buddy-up mentoring program.
    but if it doesn’t get off the ground consider Massbike and the Charlse River Wheelmen for recommended instructors.

  11. Mark wrote:

    One thing that the helmet debate often leaves out is the role of speed in injury. If you’re toodling along between walking speed and 10 miles an hour, your only real danger is getting hit by a fast moving car.

    Speed and injury are closely related. If you ride at more than 15MPH on a regular basis, wearing a helmet might be a good idea. It’s also not just the impact of speed on the human body, but your ability to avoid an accident decreases the faster you go–

    Hubway riders are by and large toodlers. I would be very surprised if there’s much more than a broken arm and some mild lacerations. Not fun, but a helmet might be of limited use there.

    I wear a helmet 90% of the time– but I think harping about helmets implies that cycling is dangerous. I would like to know what’s more dangerous–cycling without a helmet (possible trauma), or not cycling at all (sedentary lifestyle/ heart disease etc).

  12. Steve Miller wrote:

    Sam:
    You are correct that bicycling is relatively safe, and that wearing a helmet, or any other safety device in any situation, at least marginally increases people’s willingness to take risks. And you are entirely correct about the very weak research-level association between helmet use and head injuries, as well as the extremely flawed nature of the original study from which the much-quoted 85% figure is derived.

    I agree with Brad’s subsequent comment that improving bike riders skills and avoiding dangerous routes are better ways to avoid injury — to which I’d add an enormous amount of traffic calming to slow car traffic. And I agree that fear-mongering has become a central part of our culture — from movies/TV focus on crime to the Right-Wing’s hysteria about immigrants and terrorists and gays and….

    The problem is what happens to your heart and mind when you see a kid whose head was split open during a bike accident. You start thinking that it would be better if people didn’t bike rather than go through life dealing with that kind of disability — especially if you are responsible for the health and/or transportation safety of the city and you know that the media is just waiting for a chance to “expose your failures” around some specific situation.

    Yes — this is exactly where we have to start talking about the very solid data that shows that the population-level positive benefit of bicycling overwhelmingly outweighs the “cost” of injuries.

    But as we all know, statistics are dry, stories are emotional.

    Boston is about to begin a “use your helmet” campaign. It was a victory that it is an educational campaign rather than a push for a mandatory helmet use law (which we already have for people under age 16 — and which is generally ignored by almost everyone). But there is a good chance that the campaign will be entirely negative — of the “scared straight” school of “you don’t want this to happen to you; wear a helmet!” This will make it even more important for all of us to find ways to reinforce the positive message that cycling is health, useful, safe, and fun.

    Steve

  13. Steve Miller wrote:

    Mark:

    Speed is the key — both bike and car speeds. If you are going below 10 mph (as most Hubway riders are), you are very unlikely to suffer a significant head injury (possible, but not likely) unless you are hit by a car. The most important thing the city can do to prevent Hubway accidents is to do more traffic calming and install more traffic-separated cycle tracks or off-road paths.

    Steve

  14. Margot Lassen wrote:

    If a brain injury leads to memory loss, fatigue, pain, personality changes, cognitive problems or any other kind of long-term issue, the future expense could be astronomical. When you ask for a consultation, they will be able to assess the situation quickly and thoroughly to determine if you have a case and how you should proceed. If the injury resulted from malpractice, you could be entitled to compensation. Don’t wait for the situation to work itself out if harm has occurred because of someone else. Call a brain injury lawyer quickly to find out your rights.;

    My own, personal blog
    <http://www.healthmedicinelab.com/rash-around-mouth/

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